Comparative Analysis of Local Anesthetic Techniques for Pain Management in Pediatric Dental Procedures: A Randomized Clinical Trial.

Objective: The present study aims to conduct a comparative analysis of different local anesthetic techniques for pain management in pediatric dental procedures. Goal is to evaluate and compare the efficacy and safety of various local anesthetic methods to identify the most effective approach in reducing pain and discomfort during dental treatments in children. Methods: A prospective, randomized clinical trial was conducted with 60 pediatric patients (aged 3 to 10 years) undergoing dental procedures in a single dental clinic. The participants were randomly assigned into three groups: Group A received conventional infiltration anesthesia (lidocaine 2% with epinephrine 1:100,000), Group B received topical anesthesia followed by the same infiltration anesthesia, and Group C received intraosseous anesthesia using articaine 4% with epinephrine 1:100,000. The patients' demographic data, treatment details, and pre-procedure anxiety levels were recorded. Results: The study demonstrated that all three local anesthetic techniques effectively managed pain during pediatric dental procedures. However, Group C, which received intraosseous anesthesia, showed significantly lower pain scores (mean ± standard deviation) compared to Group A and Group B: 1.5 ± 0.6, 2.3 ± 0.8, and 2.1 ± 0.7, respectively (P < 0.05). Additionally, Group C exhibited a shorter onset of anesthesia compared to Group A and Group B, with mean onset times of 1.8 ± 0.4, 3.2 ± 0.6, and 2.9 ± 0.5 minutes, respectively (P < 0.001). No significant differences in adverse events or post-procedure complications among the groups. Conclusion: Intraosseous anesthesia (articaine 4% with epinephrine 1:100,000) was found most effective local anesthetic technique for pain management during pediatric dental procedures.

Comparative Evaluation of Dentinal Defects After Root Canal Preparation Using Various Nickel Titanium Files: An In Vitro Study.

AIM: This study set out to compare the damage done to dentin by three distinct titanium file brands - the Hyflex EDM, the ProTaper Next, and the Waveone Gold Nickel - in order to draw conclusions about which one is the most effective. MATERIALS AND METHODS: Forty-first premolars in the mandible with straight canals and single roots were instrumented using Hyflex EDM, Waveone Gold, and Protaper Next. Dentinal flaws after endodontic treatment were studied by sectioning specimens using a hard tissue microtome and analyzing them under a stereomicroscope. RESULTS: There was no discernible variation between the groups in the coronal third (p=0.312) or apical third (p=0.076). Hyflex EDM and Protaper Next differed significantly in the middle portion of the tape (p=0.016). The Hyflex EDM sample had the fewest cracks. There was no statistically significant difference between Hyflex EDM and Waveone Gold; however, Hyflex EDM had fewer fractures in the middle third of the sample than Waveone Gold did. CONCLUSION: Electric discharge machining (EDM) files made from Hyflex proved to be far superior to their Protaper Next and Waveone Gold counterparts as they induced the fewest cracks in the middle third of the root dentin.